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Neurocritical Care
Published in: Neurocritical Care 3/2021

Open Access 01-12-2021 | Central Nervous System Trauma | Original work

The Antiedematous Effect of Exogenous Lactate Therapy in Traumatic Brain Injury: A Physiological and Mechanistic Approach

Authors: David Emmanuel Duhaut, Catherine Heurteaux, Carine Gandin, Carole Ichai, Hervé Quintard

Published in: Neurocritical Care | Issue 3/2021

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Abstract

Background

Sodium lactate (SL) has been described as an efficient therapy in treating raised intracranial pressure (ICP). However, the precise mechanism by which SL reduces intracranial hypertension is not well defined. An antiedematous effect has been proposed but never demonstrated. In this context, the involvement of chloride channels, aquaporins, or K–Cl cotransporters has also been suggested, but these mechanisms have never been assessed when using SL.

Methods

In a rat model of traumatic brain injury (TBI), we compared the effect of SL versus mannitol 20% on ICP, cerebral tissue oxygen pressure, and brain water content. We attempted to clarify the involvement of chloride channels in the antiedematous effects associated with lactate therapy in TBI.

Results

An equimolar single bolus of SL and mannitol significantly reduced brain water content and ICP and improved cerebral tissue oxygen pressure 4 h after severe TBI. The effect of SL on brain water content was much longer than that of mannitol and persisted at 24 h post TBI. Western blot and immunofluorescence staining analyses performed 24 h after TBI revealed that SL infusion is associated with an upregulation of aquaporin 4 and K–Cl cotransporter 2.

Conclusions

SL is an effective therapy for treating brain edema after TBI. This study suggests, for the first time, the potential role of chloride channels in the antiedematous effect induced by exogenous SL.
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Metadata
Title
The Antiedematous Effect of Exogenous Lactate Therapy in Traumatic Brain Injury: A Physiological and Mechanistic Approach
Authors
David Emmanuel Duhaut
Catherine Heurteaux
Carine Gandin
Carole Ichai
Hervé Quintard
Publication date
01-12-2021
Publisher
Springer US
Published in
Neurocritical Care / Issue 3/2021
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-021-01219-y

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